Location (if the location for your event is not listed below, please use the Classroom Services Request Form):Required

Event Date:Required

Date and time

Preferred Setup Time:

Event Start Time:Required

End Time:Required

Estimated Audience Size:Required

FUAC Number:

Is this event specifically for a UWB credit-Generating Course?:Required

yesno

What is the event orientation?:Required

Audio Services

Number of wireless handhelds (4 max):

Number of wired handhelds (4 max):

Number of wireless lapel microphones (2 max):

podium microphone:

Connection for another audio device (MP3 player, etc.):

If so, please describe audio device:

Video Services

Please select all media types you plan to display during your event:

DVDVHSComputer (powerpoint, internet video, video files, etc.)

Do you plan to use your own computer?:Required

NoA Windows ComputerA Mac Computer

Miscellaneous

Number of Easels Needed:

Will you need paper pads with the easels?:

Will you need a podium?:Required

yesno

Additional Notes

Are their items not listed that you would like us to provide? Please list below:

Please Acknowledge

You should not consider your request as "completed" until you receive an official confirmation email from an I.T. staff person. If you do not receive an official confirmation email at least five business days prior to your event, call I.T. immediately.:Required

The ability to support this request is dependent upon the availability of I.T. personnel and equipment.:Required